2024 ICD-10-CM Diagnosis Code T85.9XXS

Unspecified complication of internal prosthetic device, implant and graft, sequela

ICD-10-CM Code:
ICD-10 Code for:
Unsp complication of internal prosth dev/grft, sequela
Is Billable?
Yes - Valid for Submission
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    • Complications of surgical and medical care, not elsewhere classified
      • Complications of other internal prosthetic devices, implants and grafts

T85.9XXS is a billable diagnosis code used to specify a medical diagnosis of unspecified complication of internal prosthetic device, implant and graft, sequela. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

T85.9XXS is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like unspecified complication of internal prosthetic device implant and graft. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.

Unspecified diagnosis codes like T85.9XXS are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Adverse effect of prosthetic device
  • Airway device cuff problem
  • Complication associated with device
  • Complication associated with insulin pump
  • Complication associated with nervous system implant
  • Complication associated with neurological device
  • Complication associated with saline breast implant
  • Complication associated with silicone gel-filled breast implant
  • Complication associated with vagal nerve stimulator
  • Complication of bypass graft
  • Complication of catheter
  • Complication of electronic internal device
  • Complication of internal anastomosis
  • Complication of internal device
  • Complication of internal prosthetic device
  • Complication of peritoneal dialysis
  • Complication of reimplant
  • Device failure
  • Disorder of bile duct prosthesis
  • Disorder of bile duct stent
  • Disorder of breast implant
  • Disorder of dorsal column stimulator
  • Disorder of electrodes implanted in brain
  • Disorder of esophageal tubal prosthesis
  • Disorder of implanted esophageal antireflux device
  • Disorder of intraocular lens
  • Disorder of pancreatic duct anastomosis
  • Disorder of pancreatic stent
  • Disorder of peripheral nerve graft
  • Disorder of peritoneal dialysis catheter
  • Disorder of prostheses and implants
  • Disorders of musculoskeletal implants and repairs
  • Disorders of prostheses and implants of the eye
  • Disorders of prostheses and implants of the nervous system
  • Failed insertion
  • Failed subcutaneous contraceptive insertion
  • Finding of respiratory device
  • Graft complications
  • Malposition of neurostimulator generator
  • Mechanical complication of chin prosthesis
  • Mechanical complication of peripheral nerve graft
  • Tissue expander disorder
  • Urinary tract internal anastomosis complication

Clinical Classification

Coding Guidelines

The appropriate 7th character is to be added to each code from block Complications of other internal prosthetic devices, implants and grafts (T85). Use the following options for the aplicable episode of care:

  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

Present on Admission (POA)

T85.9XXS is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.

CMS POA Indicator Options and Definitions

POA IndicatorReason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert T85.9XXS to ICD-9-CM

  • ICD-9-CM Code: 909.3 - Late eff surg/med compl
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.